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Health Information Patient Privacy Act / (HIPPA) Compliance Notice of Privacy Practices
Our Legal Duty AN & AR reserves the right to change the office’s privacy practice and the terms of this Notice at any time, provided such changes are permitted by applicable laws. AN & AR reserves the right to make changes in our privacy practices and the new terms of our Notice effective for all health information AN & AR maintains, including health information AN & AR created or received before AN & AR makes the changes. Before AN & AR makes significant changes in our privacy practices, we will change this Notice and make the new Notice available upon request. You may request a copy of this Notice at any time. For more information about our privacy practice, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice. Uses and Disclosures of Health Information AN & AR uses and discloses health information about you for treatment, payment and healthcare operations. Treatment: AN & AR may use and disclose your health information to provide, manage, and coordinate your healthcare with other health care providers involved in your care, about matters concerning your health care. This means that AN & AR will provide information about you to another physician or health care provider outside either of our clinics. For example, AN & AR would give information to your primary care physician if you had been referred to AN & AR by them for care. AN & AR would also give information to a specialist to whom AN & AR has referred you to, for care. If you would prefer that his communication not happen between AN & AR and other health care providers, you have the right to object to our sharing of this information. If AN & AR agrees to not share information with another care provider, as per your request, we will abide by the agreement. To You, Your Personal Representative and Plan Sponsor: AN & AR must disclose your health information to you, as described in the Patient Rights section of this Notice, and to a parent of a minor under the age of consent or legal guardian as necessary to help with your healthcare or with payment. AN & AR may disclose your health information to the sponsor of your health plan. Family and Friends: AN & AR may disclose health information about you to your family members or friends if we obtain your verbal or written authorization to do so, or if we give you an opportunity to object and you do not object. Using payment related to your care to your family member, other relative or close personal friend who you identify, if we can infer from the circumstances, that you would not object, for example if your spouse is a covered member with you under your health plan, or if you are involved in a health emergency situation on the premises of one of our clinics. Marketing Heath Related Services: AN & AR will NOT use your health information for marketing communications without your written authorization; except to facilitate your enrollment in a renewal of your health plan and value-added plan insurance services permitted by law. Required by Law: AN & AR may use or disclose your health information when we are required to do so by federal, state, or local law or legal process; for example subpoena, court order, administrative order, warrant, or summons; and pursuant to worker’s compensation laws. Abuse or Neglect: AN & AR may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes. AN & AR may disclose your health information to the extent necessary to avert a serious threat to your health or safety of others. Plan Communication: AN & AR may use or disclose your health information to communicate with you or your plan sponsor about your health and related benefits and services. Government Officials and Law Enforcement: AN & AR may disclose to authorized governmental authorities health information required for lawful investigation; to military authorities required for lawful investigation; to military authorities the health information of Armed Forces personnel; to a correctional institution or law enforcement officials having lawful custody of health information under certain circumstances. In most cases, we will make all reasonable attempts to contact you to inform you of any such disclosures, unless prohibited by law. Your Authorization: Other uses and disclosures of your protected health information will only be made with you or your Personal Representative’s written authorization. You may revoke such authorization at any time by written request, but we can not take back any disclosures already made or used with your permission.
Patient Rights Restriction: You have the right to request in writing that AN & AR place additional restrictions on our use of your health information. AN & AR is not required to agree to these additional restrictions, but if we do, we will abide by our agreement, except in an emergency or as required by law. Amendment: You have the right to request that AN & AR amend your health information. Your request must be in writing and it must explain why the information should be amended. AN & AR may deny your request under certain circumstances. Patients have a right to disagree with our refusal of inclusion, and AN & AR also has the right to rebut a patient’s disagreement; any time a file is sent out, a copy of that rebuttal must be included. Questions and Complaints:br If you want more information about our privacy practice or have any questions or concerns, please contact AN & AR. If you are concerned that AN & AR has violated your privacy rights, or if you disagree with a decision we have made about access to your health information, or in response to a request you made to amend or restrict the use of disclosure of your health information, or to have us communicate with you by alternative means or at alternative locations, you may complain to Dr. Young at the address listed at the end of this notice. We support your right to the privacy of your health information. You will not be penalized in any way if you choose to file a complaint with AN & AR or with the U.S. Department of Health and Human Services. To contact AN & AR or Dr. Young about Patient Rights information and / or complaints, please use the following information:
Absolute Nutrition & Accident Recovery, Inc.
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